Individual
BRIAN ALAN MABRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BRIAN MABRY
Contact information
Practice address
66 N 6TH ST, POMEROY, WA 99347-9705
(509) 843-1591
(509) 843-1234
Mailing address
66 N 6TH ST, POMEROY, WA 99347-9705
(509) 843-1591
(509) 843-1234
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA60564965
WA
363AM0700X
Medical Physician Assistant
Primary
50.003623
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20358733200
BWC GROUP
OH
05
—
2630700
—
OH
Enumeration date
10/05/2012
Last updated
05/06/2016
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